Healthcare Provider Details

I. General information

NPI: 1184706087
Provider Name (Legal Business Name): OUR COMMON WELFARE,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3423 COVINGTON DR SUITE E
DECATUR GA
30032-1846
US

IV. Provider business mailing address

3423 COVINGTON DR SUITE B
DECATUR GA
30032-1846
US

V. Phone/Fax

Practice location:
  • Phone: 404-284-9878
  • Fax: 404-284-9972
Mailing address:
  • Phone: 404-284-6061
  • Fax: 404-284-9972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA BROWN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 404-284-6061